족저근막 파열의 임상양상

이호승,이종윤,정재중,Lee, Ho Seong,Lee, Jong Yoon,Jeong, Jae Jung 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.1

Purpose: The purpose of this study is to analyze the clinical features of plantar fascia rupture. Materials and Methods: We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture. Results: Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was $58.29{\pm}12.54years$. The mean VAS score was 5.92 points (3~9 points). The mean BMI was $25.92{\pm}1.59kg/m^2$. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients-out of 36 chronic plantar fascia rupture, there were no subjective symptoms. Conclusion: Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.

방광 파열을 동반한 골반 골절

이상홍(Sang Hong Lee),송경철(Kung Chul Song),박상하(Sang Ha Park),박치형(Chi Hyoung Park),조승환(Sueng-Hwan Jo),임동훈(Dong Hoon Lim) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.3

목적: 골반 골절과 동반되어 발생하는 방광 파열에 대해 골반 골절의 손상 기전과 방광 손상의 형태 및 치료에 대해 알아보고자 하였다. 대상 및 방법: 2002년 9월부터 2011년 2월까지 골반 골절로 치료 받고 1년 이상 추시가 가능했던 방광 파열이 동반된 골반 골절 환자 56예를 대상으로 골반 골절의 손상 기전의 분류는 Young 등의 분류, 방광 파열의 형태는 복강 내 방광 손상, 복강 외 방광 손상, 복강 내, 외 방광 손상으로 분류한 후 골반 골절의 형태에 따른 방광 손상을 후향적으로 조사하여 그 연관성을 검증하고자 하였다. 결과: 방광 파열이 동반된 골반 골절 환자 56예 중 남자 34예(60.7%), 여자 22예(39.3%)였으며 평균 연령은 58.2 (19-84)세였다. 원인은 교통사고가 41예, 손상 기전은 측방 압박 손상 23예로 가장 많았으며, 해부학적 분류상 38예(67.9%)에서 치골지 골절이 발생하였다. 방광 파열은 복강 내 파열 17예, 복강 외 파열 37예, 복강 내, 외 동반 파열은 2예였으며 복강 내 파열과 복강 내, 외 동반 파열은 전 예에서, 복강 외 파열은 6예(10.7%)에서 수술이 시행되었다. 방광 파열에 대해 수술을 시행 받은 25예 중 13예에서, 방광 파열에 대해 보존적 치료를 시행했던 31예 중 5예에서 각각 골반 골절에 대해 수술을 시행하였다. 결론: 방광 파열이 동반된 골반 골절에 있어서 측방 압박 손상이 가장 많았으며 전위가 심하지 않은 골반 골절 및 저에너지 손상에서도 방광 파열은 발생하였다. Purpose: The purpose of this study was to evaluate the injury mechanism of pelvic bone fracture and injury type and treatment of bladder rupture associated with pelvic bone fracture. Materials and Methods: From September 2002 to February 2011, we treated pelvic bone fracture with bladder rupture in 56 cases with minimal follow up of one year. Each of the 56 cases was classified into groups depending on the mechanism of pelvic fracture (Young classification) and the aspect of bladder rupture (intraperitoneal rupture, extraperitoneal rupture, combined rupture) after which the relationship between the two aspects was analyzed retrospectively. Results: There were a total of 56 cases where bladder ruptures occurred in association with pelvic bone fractures; 34 patients were men and 22 patients were women. The average age was 58.2 years (range: 19-84). Traffic accidents were the main cause of pelvic bone fractures with bladder ruptures in 41 cases. The main injury mechanism was lateral compression, and pubic ramus fractures occurred in 38 cases (67.9%). Regarding the classifications of bladder ruptures, there were 17 cases of intraperitoneal rupture, 37 cases of extraperitoneal rupture, and two cases of combined rupture. Operations were performed on all cases of intraperitoneal and combined rupture and on six cases of extraperitoneal rupture. Conclusion: Lateral compression was the most common injury of bladder rupture in pelvic bone fracture. Bladder ruptures occurred even in cases where the displacement of pelvic bones was not severe and also in cases of low energy injury.

A Retrospective Analysis of Ruptured Breast Implants

백우열,유대현,이동원 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.6

Background: Rupture is an important complication of breast implants. Before cohesive gelsilicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related toruptured implants. Methods: We performed a retrospective review of 72 implants that were removed forimplant rupture between 2005 and 2014 at a single institution. The following data werecollected: type of implants (saline or silicone), duration of implantation, type of implant shell,degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, andmanagement. Results: Forty-five Saline implants and 27 silicone implants were used. Rupture wasdiagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants,respectively. There was no association between shell type and risk of rupture. Spontaneouswas the most common reason for the rupture. Rupture management was implant change (39case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions: Saline implants have a shorter average duration of rupture, but diagnosis iseasier and safer, leading to fewer complications. Previous-generation silicone implantsrequired frequent follow-up observation, and it is recommended that they be changed to acohesive gel implant before hidden rupture occurs.

풍선확장술에 의하여 초래된 식도천공의 새로운 진단방법

송호영 대한영상의학회 1990 대한영상의학회지 Vol.26 No.5

The diagnosis of esophageal rupture in ballon dilatation is usually made from clinical symptom of sharp chest pain, plain chest radiographs and esophagograms after dilatation. It has some problems ; the pain is varied patients to patients and bacterial flora in the mouth or esophagus can be mixed with the contrast media to flow into the mediastinum during esophagography, to create mediastinitis. We could make the diagnosis of esophageal rupture without using contrast media by the observation of the pressure change in the ballon during dilatation An infusion pump, transducer and esophageal balloon were connected through a multi-way connector, and the transducer of them was also connected to an amplifier which was connected to a pressure monitor to record the balloon pressure. A balloon(20m./3㎝) inserted in the mid-thoracic esophagus under the fluoroscopic control was inflated until the esophagus was ruptured. Balloon was distended by injecting air in 15 rabbits(A group), and b injecting diluted contrast medium in 15 rabbits(B group). The pressure decrease after esophageal rupture was ranged from 94 to 160mmHg(mean ; 103) in A group and 340 to 1040 mmHg(mean ; 537 ) in B group. The pressure curve of A group was smooth, regular and so accurate to make the diagnosis of esophageal rupture, whereas that of B group was irregular and not so accurate. In conclusion, our new method to ma다 the diagnosis of esophageal rupture during balloon dilatation may be useful in patients of esophageal stricture. The diagnosis of esophageal rupture in ballon dilatation is usually made from clinical symptom of sharp chest pain, plain chest radiographs and esophagograms after dilatation. It has some problems ; the pain is varied patients to patients and bacterial flora in the mouth or esophagus can be mixed with the contrast media to flow into the mediastinum during esophagography, to create mediastinitis. We could make the diagnosis of esophageal rupture without using contrast media by the observation of the pressure change in the ballon during dilatation An infusion pump, transducer and esophageal balloon were connected through a multi-way connector, and the transducer of them was also connected to an amplifier which was connected to a pressure monitor to record the balloon pressure. A balloon(20m./3cm) inserted in the mid-thoracic esophagus under the fluoroscopic control was inflated until the esophagus was ruptured. Balloon was distended by injecting air in 15 rabbits(A group), and b injecting diluted contrast medium in 15 rabbits(B group). The pressure decrease after esophageal rupture was ranged from 94 to 160mmHg(mean ; 103) in A group and 340 to 1040 mmHg(mean ; 537 ) in B group. The pressure curve of A group was smooth, regular and so accurate to make the diagnosis of esophageal rupture, whereas that of B group was irregular and not so accurate. In conclusion, our new method to make the diagnosis of esophageal rupture during balloon dilatation may be useful in patients of esophageal stricture.

A Retrospective Analysis of Ruptured Breast Implants

Baek, Woo Yeol,Lew, Dae Hyun,Lee, Dong Won Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.6

Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants. Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management. Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

원발성 간암파열환자에서 그 생존에 영향을 미치는 인자

안병철(Byeong Cheol Ahn),이양일(Yang Il Lee),최성곤(Seng Gon Choi),권중구(Joong Gu Kwen),이창형(Chang Hyung Lee),윤영미(Young Mee Yun),탁원영(Won Young Tak),관규식(Kyu Shik Kwak),최용환(Yong Hwan Choi),정준모(Joon Mo Chung) 대한내과학회 1994 대한내과학회지 Vol.46 No.1

N/A Background: Even though the hepatoma rupture has been known to be one of the fatal complications of hepatoma, the detailed studies on it were few in Korea. Methods: In order to investigate whether the he- patoma rupture can affect the survival of hepatoma patients or not, and also which factors can influence the prognosis of patients with hepatoma rupture, we studied 67 patients with hepatoma rupture and 74 age-matched hepatoma patients without rupture. Results: 1) Incidences of cirrhosis, ascites, hepatic encephalopathy, and unfavorable grade of Child`s classification were more prevalent in rupture group than in control group. Rupture group showed lower mean values of hemoglobin, prothrombin time, total protein and albumin, and higher mean level of GOT than those of control group. 2) But, there was no significant difference in survival time between rupture group and control group. 3) In rupture group, the survival time was more prolonged in patients with more favorable grade of Child`s classification, The survival time tended to be more prolonged in patients treated with TAE method than those managed with conservative treatment, but unfortunately, the results was statistically not significant, 4) In control group, survival time was prolonged in patients with more favorable grade of Child's classification and in those treated with TAE method. Conclusion: Treatment modality and liver status are most significant prognostic factors in hepatoma rupture patients and TAE method should be considered.

복부대동맥류 파열의 임상적 고찰

임승택,김영균,황정기,김상동,박순철,원용성,박장상,김지일,윤상섭,문인성 대한혈관외과학회 2011 Vascular Specialist International Vol.27 No.3

Purpose: With current advances in surgical technique, the prognosis for elective open repair of abdominal aortic aneurysm (AAA) has improved, but the mortality rate for ruptured AAA remains high. The aim of this study was to define the risk factors of AAA rupture. Methods: We performed a retrospective analysis of 169 AAA patients who underwent open surgical repair between March 2000 and October 2010. According to the rupture, the patients were divided into 2 groups:‘ruptured’ (n=41), ‘non-ruptured’ (n=128). To define the risk factor of ruptured AAA, we compared following variables between the 2 groups: clinical co-morbidities (hypertension, diabetes mellitus, ischemic heart disease,malignancies), diameter (maximal diameter of AAA), location of rupture, gender, and previous abdominal surgery history. Results: Mean patient-age was 68.4±4.4 years (range: 32 to 86 years); the majority of patients were males,135 (79.8%). Mean diameter of AAA was 6.67±2.0 cm (range: 4 to 15 cm); ‘non-ruptured’: 6.3±1.6 cm,‘ruptured’: 7.8±2.6 cm. The risk of AAA rupture was statistically significantly increased with increased diameter of the AAA (P=0.007). On multivariateanalysis, the only statistically significant risk factor for AAA rupture was diameter of AAA (P=0.004). Conclusion: The only significant risk factor for AAA rupture found in this study is the diameter of AAA. To minimize the rupture rate of the AAA patients, we will have to closely monitor the size of AAA diameter.

수술 중 뇌동맥류 파열에 대한 임상 분석

백원철,고현송,김윤,Baek, Won-Cheol,Koh, Hyeon-Song,Kim, Youn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Objective : Intraoperative rupture of an intracranial aneurysm can interrupt a microsurgical procedure and jeopardize the patient's chance to favorable outcome. The purpose of this study was to analyse and evaluate intraoperative aneurysmal rupture and render ideal prevention and management to intraoperative rupture. Patients and Methods : The authors retrospectively analysed the results of 609 patients who underwent cerebral aneurysm surgery from January 1991 to December 2000. Results : 1) Intraoperative aneurysmal rupture occurred in 73 of 609 consecutive aneurysm surgery, so the incidence was about 12.0% and it was relatively lower than other reports. 2) Aneurysms arising from anterior communicating artery appeared more prone to intraoperative rupture. 3) The size of aneurysm and timing of operation didn't influence intraoperative aneurysmal rupture and temporary clipping didn't reduce the incidence of intraoperative aneurysmal rupture. 4) Intraoperative aneurysmal rupture occured during three specific periods : (1) dissection stage in 61%, (2) clip application stage in 29 %, (3) predissection stage in 10%. 5) In the patients with intraoperative aneurysmal rupture, surgical outcome was relatively good and there was no significant difference in outcome compared with unruptured group. Conclusion : Our suggestion for prevention methods of intraoperative aneurysmal rupture are as follows : 1) minimal brain retraction, 2) sharp and careful aneurysmal neck dissection, 3) gentle clipping with proper clip selection etc. Management methods after intraoperative aneurysmal rupture are as follows : 1) strong aspiration of bleeding point, 2) rapid application of temporary and/or tentative clip, 3) following rapid dissection of neck and proper clip application, 4) use of encircling clip etc.

전경골건 파열의 임상 양상

박상은,전현식,정재중 대한족부족관절학회 2023 대한족부족관절학회지 Vol.27 No.3

Purpose: Tibialis anterior tendon rupture is uncommon and usually caused by laceration. Rupture with an open window is often consid- ered simple laceration, and thus diagnosis is often overlooked or delayed. The purpose of this study was to analyze the clinical features of tibialis anterior tendon rupture. Materials and Methods: Twenty-two patients treated for tibialis anterior tendon rupture from March 2015 to December 2019 were ex- amined. Age, sex, rupture etiology, rupture location, and diagnostic and treatment delays were investigated. Results: Mean patient age was 45.7 years, and there were 14 males and 8 females. In 18 cases, rupture was caused by laceration and in 4 by spontaneous rupture. Of the 18 cases caused by laceration, 8 were lawnmower related, 8 were glass injuries, and 2 were caused by crush or degloving injuries, respectively. Three of the 4 spontaneous rupture cases and 4 of the 18 caused by laceration were overlooked. Conclusion: Tibialis anterior tendon rupture is rare and is easily overlooked. Close physical examination is essential to arrive at a correct initial diagnosis in patients with acute or chronic rupture, and greater care is needed in cases of glass injury.

바슐라르의 '단절' 개념에 대한 세 물음과 그 해명

김윤재(Yun-Jae Kim),박치완(Tchi-Wan Park) 중앙대학교 중앙철학연구소 2010 철학탐구 Vol.27 No.-

바슐라르의 인식론을 검토하고자 하는 본 연구는 그의 ‘단절(la rupture)"이라는 개념을 살펴보는 것을 목표로 한다. 그의 단절 개념은 인식론 관련 저작의 처음부터 끝까지 등장하면서 다듬어지고 복잡화되는 개념이다. 그 만큼 단절 개념은 실제 그의 인식론적 체계 내에서 매우 중요한 위치를 점하고 있고, 또 그런 만큼 그의 인식론 전체를 조망하기 위해서도 반드시 연구되어야 할 개념이라고 생각된다. 따라서 단절 개념과 함께 바슐라르 인식론 전체를 파악하고자 하는 것이 본 연구의 목표인 바 우리는 이를 다음과 같이 셋으로(<어디에서>, <무엇과>, <무엇을 통해>)세분화시켜 그 물음과 해명을 이제까지의 논의들과는 다른 해석을 시도해보고자 한다. <어디에서>라는 물음을 통해서는 바슐라르가 그 시대의 사람들에게 주요하게 받아들여진 실증주의적인 관점의 과학의 역사 해석, 즉 일반과학(und science general)"이라는 이념에 입각하여 점진적인 확장과 발전으로서 과학의 역사를 받아들이는 입장에서 어떻게 맞서는지를 확인하게 될 것이다. 바슐라르는 당시의 과학적 성과가 보인 혁신적 이행, 즉 기존의 이론이 새로운 이론과 시간적 선후관계나 인과적인 관계를 맺는 것이 아니라, 새로운 이론들은 기존의 이론으로부터 단절되어 나타나며, 기존의 이론들은 이를 통해 새로운 이론들에 의해 재평가되고 새로운 이론적 틀에서 재배치된다는 점을 강조한다. <무엇과>의 단절이라는 물음을 통해서는 바슐라르 인식론의 독특한 개념인 ‘인식론적 장애(I"obstacle epistemologique)와 우리가 어떻게 거리를 두어야 하는지를 보게 될 것인데, 특히 여기서는 상식과 최초의 관찰과의 단절이 강조된다. 바슐라르에 따르면 새로운 과학적 이론을 받아들임에 있어, 대상에 대해 갖고 있는 최초의 관찰이나 기존의 과학적 지식이 일반화된 상태인 상식은 대개가 장애로 작동한다는 것이다. 때문에 우리가 새로운 과학 이론을 받아들이기 위해서는 최초의 관찰 결과나 기존의 상식과 반드시 단절해야만 한다는 것. 마지막으로 <무엇을 통해>라는 물음을 통해서는 현대 과학이 어떻게 인간의 일상적인 인식과 구분되어 과학적 인식에 도달하는지를 검토하게 될 것이다. 현대 과학은 새로운 실험 기술들을 통해 과학적 대상에 간접적인 접근을 시도한다. 그렇다고 해서 새로운 실험 기술들에 의해서만 현대 과학의 성과들이 산출되는 것은 아니다. 이 성과들은 이론적 사유, 즉 실험에 대한 창조적 기획과 실험 도구가 맞물려 이루어진다. 그렇기에 현대 과학의 대상들은 우리에게 주어진 것이 아니라, 우리가 그것을 창안하는 것임을 살펴보게 될 것이다. 결론적으로 본 연구에서 우리는 위 세 물음과 해명이 곧 바슐라르 인식론의 ‘역동성’을 구성한다는 것을 밝히면서, 이러한 역동성이야말로 바슐라르 인식론 전체에서 작동되는 ‘운동’ 그 자체라는 점을 강조해보고자 한다. To study Bachelard’s epistemology, this article takes the concept of ‘la rupture’ as theme. As the rupture has been continuously grown up by adjusted and complicated through whole of his works of epistemology, the importance of the rupture in his epistemology proves that rupture is the most suitable tool to overview his entire epistemology itself. So this article consists of three questions about the rupture and its explanations. The rupture <from where>, <from what>, <by what> are the questions. Through the question of <from where>, we can see what is the critique of Bachelard about the positivist’s understanding of the history of natural science. That understanding is based on the idea of the general science(une science du general), that the history of natural science has been gradually expanded and developed. On the contrary, Bachelard emphasizes the history of natural science as renovative and continuous movement. In the modern physics, the former theory hasn`t any causal relation to a latter theory. Rather, the former has been revaluated by the latter, and relocated in the new theoretical system. On the question of <from what>, we will see that rupture from a epistemological obstacle, as a unique concept of Bachelard’s epistemology, especially we will treat rupture of the common sense and the prior or the first view. To accept an outcome of new theory of natural science, the common sense and the first view work as the epistemological obstacle. Bachelard insists on that if we want to accept a new theory of natural science, we must rupture from the first view and the common sense, because a new theory has no theoretical relation to the former theory. On the question of <by what>, we will see that how the contemporary science makes difference between connaissance commune and connaissance scienfitique. The contemporary science indirectly accesses to scientific object by new experimental instrument. But it is not that a outcome of contemporary science is produced only by new experimental instrument. That outcome has been produced by the ensemble of the theoretical thought, in other words, the creative plan about an experiment and the experimental instrument. by these reasons, we will see that the object of contemporary science is not given to us, but created by us. In conclusion, we claim that questions the rupture <from where>, <from what>, <by what>, and explanations of three aspects of rupture are summarized to the dynamic of Bachelard’s epistemology. We conclude the dynamic, that is the movement what operates in his epistemology.